Top 100 most-cited articles on pediatric anesthesia from 1990 to 2023.

Pediatric anesthesia presents greater challenges than does adult anesthesia. This bibliometric analysis aimed to analyze the top 100 most cited articles to be better understand the hot spots and prospects in pediatric anesthesia. Articles and reviews related to pediatric anesthesia were retrieved from the Web of Science Core Collection from 1990 to 2023. A bibliometric analysis of the top 100 most cited articles was also performed using information such as topics, author names, countries, institutions, publication years, and journals. A total of 32 831 articles were identified, with a total of 32 230 citations for the top 100 articles. The peak period for pediatric anesthesia research was from 2005 to 2009. The USA has emerged as the most active country in pediatric anesthesia research. Major journals published included Anesthesia and Analgesia, Anesthesiology, and Pediatrics, underscoring their authority in the field. Clinical studies on the top 100 most cited articles have focused on different stages of the perioperative period, the use of different anesthetic agents, and adverse outcomes in pediatric patients. The current study conducted a bibliometric analysis of the top 100 most cited articles in the field of pediatric anesthesia. Such insights are valuable for identifying research hot spots, assessing academic impact and collaboration in pediatric anesthesia, and guiding future research directions.

High-intensity ultrasound-modified Jerusalem artichoke leaf protein for stabilizing corn oi-in-water emulsion and Enhacing curcumin delivery.

Jerusalem artichoke leaf protein (JALP) has limited applications because of its dark color, even though Jerusalem artichoke is a cash crop. This study utilized high-intensity ultrasound (HIUS) (≤ 600 W) to modify the physicochemical characteristics and functional properties of JALP. Compared with the JALP, all the HIUS-treated JALP (UJALP) samples had a lighter brown color, higher absolute ζ-potential value, lower Z-average size, higher surface hydrophobicity, higher water solubility, lower turbidity, more -SH group, and higher water-holding, oil-holding, emulsifying and foaming capacities. The HIUS treatment disrupted certain non-covalent and SS bonds, promoted protein depolymerization, change protein secondary structures, causing partial unfolding of protein and exposure of some charged groups, hydrophobic groups and chromophores (like tryptophan and tyrosine). The UJALP-stabilized corn oil-in-water emulsions (UJALPEs) were more stable than the JALP-stabilized emulsion (JALPE). The bioaccessibility of curcumin in the JALPE (56.38 %) was significantly lower than in the UJALPE-600 W (64.59 %).

Association between obesity and sleep disorder in the elderly: evidence from NHANES 2005-2018.

Background: The available data exhibit inconsistent findings regarding the association between obesity and sleep problems among older adults. The objective of this study was to assess the potential association between obesity and sleep disorders in the older population. Methods: The data utilised in this cross-sectional investigation was obtained from the National Health and Nutritional Examination Survey (NHANES) conducted between 2005 and 2018. The study employed a multivariate logistic regression model and conducted subgroup analysis to evaluate the association between obesity and sleep disturbance. Results: The investigation consisted of 2,570 older people who provided complete information, out of which 324 individuals satisfied the criteria for sleep disturbance. The findings from the multivariable adjusted logistic regression model indicate that individuals in the overweight and normal weight groups exhibited decreased odds of experiencing sleep disorder, as evidenced by the adjusted odds ratios (AOR) of 0.46 (95% confidence interval [CI] = 0.34-0.61) and 0.33 (95% CI = 0.22-0.47), respectively. These results were statistically significant (p < 0.001) when compared to individuals in the obese group. The investigation of age and gender subgroups demonstrated similar associations between various BMI categories and sleep disorders in the older population. Conclusion: In summary, there exists a correlation between obesity and sleep disorders in the senior population. A significant association was observed between BMI and the likelihood of experiencing sleep disorders, indicating a dose-response relationship. Individuals with a higher BMI demonstrated a heightened likelihood of experiencing sleep disorders compared to those with a lower BMI.

Bibliometric Analysis of TREM2 (2001-2022): Trends, Hotspots and Prospects in Human Disease.

Background: Triggering receptor expressed in myeloid cells 2 (TREM2), a transmembrane receptor, has garnered extensive research attention due to its pivotal role in the diagnosis and treatment of various diseases. Despite the abundance of studies on its function, there is a gap in comprehensive analysis and summarization of the current state of this research field. Methods: Articles and reviews related to TREM2 were retrieved from the Web of Science Core Collection (WOSCC) on October 1, 2023. A bibliometric analysis of TREM2 was conducted using CiteSpace, VOSviewer and Bibliometrix (R package). Results: A total of 1,502 articles, spanning from 2001 to 2022, met the search criteria. The number of publications and citations has increased steadily over the years. The United States and China are the most active countries in TREM2 research, with the University of Washington as the leading research institution. The most influential journal in the field is Neurology of Aging. The predominant research areas include molecular, biology and immunology. Alzheimer's disease, microglia, variants, and inflammation are significant keywords. Emerging directions such as metabolism and tumor microenvironment have recently gained attention in numerous studies. Conclusion: The current study utilizes bibliometric analysis software and visual graphics to intuitively highlight TREM2-related hotspots, trends, and prospects in human disease. Such insights are valuable for scholars seeking a deeper understanding of TREM2-related research progress, enabling a focused approach to its application in human disease.

A Comparative Study on the Composition and Structure of Human Milk Phospholipids and its Natural Resources: Based on a Similarity Evaluation Model.

Human milk phospholipids (HMPLs) play an indispensable role in the neurodevelopment and growth of infants. In this study, a total of 37 phospholipid fatty acid (PLFA) species and 139 phospholipid molecular species were detected from human milk and other natural phospholipid sources (including 5 animal-derived species and 2 plant species). Moreover, a similarity evaluation model for HMPLs was established, including phospholipid classes, PLFAs, and phospholipid molecular species, to evaluate their natural substitutes. The closest scores for HMPL substitute in these three dimensions was 0.89, 0.72, and 0.77, which belonged to mare milk, goat milk, and camel milk, respectively. The highest comprehensive similarity score was obtained by camel milk at 0.75, while the lowest score was observed in soybean phospholipid (0.22). Therefore, these results not only monitored the stereochemical structure of HMPLs and their substitutes, but also further provided new insights for the development of infant formulae.

The Relationship between Parental Educational Involvement and Learning Engagement among Chinese Middle School Students: The Mediating Effect of Gratitude and Hope.

Despite the extensive body of literature on the correlation between family dynamics and academic achievement among students, there remains a notable gap in research investigating the influence of parental educational involvement on student learning engagement. Based on the developmental-ecological model of student engagement and relevant theoretical frameworks, this study used the quantitative analysis method to construct a chain mediation model to test the relationship between parental educational involvement and the learning engagement of middle school students, as well as the potential mediating role of gratitude and hope. This study employed a cross-sectional study using whole-cluster random sampling to measure middle school students aged 11-18 years old in two schools over a one-week period. Through the use of self-reporting surveys, this study assessed the levels of parental educational involvement, gratitude, hope, and learning engagement among 754 middle school students (48% female; Mage = 14.83, SD = 1.65) in Hubei Province, China. The mediation effect was analyzed using regression analysis and the chained mediation model and tested via the Bootstrap method. The findings suggested that parental educational involvement significantly positively related to learning engagement among middle school students, while gratitude and hope serve as partial mediators in the relationship between parental educational involvement and learning engagement. These findings revealed the psychological mechanisms underlying the relationship between parental educational involvement and learning engagement among middle school students, providing valuable insights for enhancing their level of learning engagement.

Effects of high pressure processing on structural changes, aggregation, and binding mechanisms of ß-Lactoglobulin with typical polyphenols.

The binding capacity of ß-Lactoglobulin (BLG) is crucial for delivering polyphenols, influenced by structural changes. High pressure processing (HPP) has the potential to modify BLG's structure and aggregation, but its specific impact on BLG-polyphenol interactions is uncertain. This study used circular dichroism spectroscopy and molecular dynamics simulations to reveal HPP-induced structural changes in BLG, supported by particle size analysis indicating aggregation. Seven structurally diverse polyphenols (quercetin-QR, hesperetin-HSP, dihydromyricetin-DHM, gallic acid-GA, (-)-epicatechin-EC, resveratrol-RES, and secoisolariciresinol diglucoside-SDG) were investigated to comprehensively analyze their binding patterns using fluorescence spectroscopy and molecular docking. HPP reduced BLG's ordered structure and increased its aggregation. Binding affinities peaked at 400 MPa for DHM, QR, HSP, GA, and RES, while SDG and EC exhibited maximum affinities at atmospheric pressure and 600 MPa, respectively. Elevated pressures enhanced BLG-polyphenol interactions, particularly at residues 44GLU and 160CYS, with van der Waals forces dominating the binding free energy.

Serum carotenoid levels inversely correlate with depressive symptoms among adults: Insights from NHANES data.

BACKGROUND: Carotenoids are a group of tetraterpenoid lipophilic pigments linked to depression, but studies on individual carotenoid components are lacking. We aimed to assess the association between each serum carotenoids and depressive symptoms in adults. METHODS: This cross-sectional study included 7264 adults from the National Health and Nutrition Examination Survey (NHANES). Serum carotenoid levels (α-carotene, ß-carotene, ß-cryptoxanthin, lycopene, and lutein/zeaxanthin) were measured using high-performance liquid chromatography. Participants with a Patient Health Questionnaire score ≥ 10 were considered to have depressive symptoms. The association between each carotenoid and depressive symptoms was investigated using multivariable-adjusted logistic regression, restricted cubic spline, and weighted quantile sum regression models. RESULTS: The participants' average age was 46.0 (interquartile range: 34.0-60.0) years (50.9 % females), and 545 participants (7.5 %) were diagnosed with depressive symptoms. The logistic regression model demonstrated that high serum α-carotene, ß-carotene, ß-cryptoxanthin, and lutein/zeaxanthin levels were associated with a lower likelihood of depressive symptoms. The restricted cubic spline model revealed that the significantly inverse relationships between serum carotenoid levels and the risk of depressive symptoms were nonlinear for α-carotene, ß-carotene, ß-cryptoxanthin, and lutein/zeaxanthin and were linear for lycopene. The threshold effect analysis further identified the inflection points were 12.1, 35.7, 5.9, and 7.7 µg/dL for α-carotene, ß-carotene, ß-cryptoxanthin, and lutein/zeaxanthin, respectively. The weighted quantile sum regression model revealed that ß-cryptoxanthin (35.2 %) and α-carotene (34.5 %) were the top-weighted carotenoids correlated with depressive symptoms. CONCLUSIONS: The present results suggested an association between higher levels of each serum carotenoids and a decreased risk of depressive symptoms in adults.

Microglial AKAP8L: a key mediator in diabetes-associated cognitive impairment via autophagy inhibition and neuroinflammation triggering.

BACKGROUND: Diabetes-associated cognitive impairment (DACI) poses a significant challenge to the self-management of diabetes, markedly elevating the risk of adverse complications. A burgeoning body of evidence implicates microglia as a central player in the pathogenesis of DACI. METHODS: We utilized proteomics to identify potential biomarkers in high glucose (HG)-treated microglia, followed by gene knockdown techniques for mechanistic validation in vitro and in vivo. RESULTS: Our proteomic analysis identified a significant upregulation of AKAP8L in HG-treated microglia, with concurrent dysregulation of autophagy and inflammation markers, making AKAP8L a novel biomarker of interest. Notably, the accumulation of AKAP8L was specific to HG-treated microglia, with no observed changes in co-cultured astrocytes or neurons, a pattern that was mirrored in streptozotocin (STZ)-induced diabetic mice. Further studies through co-immunoprecipitation and proximity ligation assay indicated that the elevated AKAP8L in HG-treated microglial cells interacts with the mTORC1. In the STZ mouse model, we demonstrated that both AKAP8L knockdown and rapamycin treatment significantly enhanced cognitive function, as evidenced by improved performance in the Morris water maze, and reduced microglial activation. Moreover, these interventions effectively suppressed mTORC1 signaling, normalized autophagic flux, mitigated neuroinflammation, and decreased pyroptosis. CONCLUSIONS: Our findings highlight the critical role of AKAP8L in the development of DACI. By interacting with mTORC1, AKAP8L appears to obstruct autophagic processes and initiate a cascade of neuroinflammatory responses. The identification of AKAP8L as a key mediator in DACI opens up new avenues for potential therapeutic interventions.

Long-Lifespan Fibrous Aqueous Ni//Bi Battery Enabled by Bi2O3-Bi2S3 Hierarchical Heterostructures.

Bismuth oxide (Bi2O3) materials are considered as great promising anodes for aqueous batteries on account of the high capacity as well as wide potential plateau. Nevertheless, the low conductivity and severe volumetric change of Bi2O3 in the course of cycling are the main limiting factors for their application in energy-storage systems. Herein, we propose and design unique hierarchical heterostructures constructed by Bi2O3 and Bi2S3 nanosheets (NSs) manufactured immediately on the surface of carbon nanotube fibers (CNTFs). The Bi2O3-Bi2S3 (BO-BS) exhibits enhanced conductivity and increased stability in comparison with pure Bi2O3 and Bi2S3. The BO-BS NSs/CNTF electrode indicates exceptional rate capability and cycling stability, while creating a high reversible capacity of 0.68 mAh cm-2 at 4 mA cm-2, as anticipated. Additionally, the quasi-solid-state fibrous aqueous Ni//Bi battery that was built with the BO-BS NSs/CNTF anode delivers an exceptional cycling stability of 52.7% capacity retention after 4000 cycles at 80 mA cm-2, an ultrahigh capacity of 0.35 mAh cm-2 at 4 mA cm-2, and a high energy density of 340.1 mWh cm-3 at 880 mW cm-3. This work demonstrates the potential of constructing hierarchical heterostructures of bismuth-based materials for high-performance aqueous Ni//Bi batteries and other energy-storage devices.

Regulating Water Adsorption Sites of Keto-Enamine COF by Base Exfoliation and Deprotonation for Enhanced Humidity Response.

Covalent organic framework (COF) has received much attention owing to its unique framework structure formed by diverse organic units. However, challenges, including low conductivity, structure instability, and limited control of adsorption and desorption processes, stimulate the modification of COF in electronic sensors. Herein, inspired by the alterable structure of COF in different solvents, a facile base exfoliation and deprotonation method is proposed to regulate the water adsorption sites and improve the intrinsic conductivity of TpPa-1 COF. TpPa-1 COF powders are exfoliated to nanosheets to increase water adsorption, while the deprotonation is utilized to adjust the affinity of water molecules on TpPa-1 COF framework, contributing to water accumulation in the 1D pores. The as-fabricated TpPa-1 COF sensor exhibits a decreased recovery time from 419 to 49 s, forming a linear relation between relative humidity (RH) value and humidity response. The excellent chemical stability of the covalent bond of TpPa-1 COF contributes to the excellent stable device performance in 30 days, promoting further integration and data analysis in respiration monitoring.

Bioactive sulforaphane from cruciferous vegetables: advances in biosynthesis, metabolism, bioavailability, delivery, health benefits, and applications.

Chronic inflammation-induced diseases (CID) are the dominant cause of death worldwide, contributing to over half of all global deaths. Sulforaphane (SFN) derived from cruciferous vegetables has been extensively studied for its multiple functional benefits in alleviating CID. This work comprehensively reviewed the biosynthesis, metabolism, bioavailability, delivery, health benefits, and applications of SFN and its potential mechanisms against CID (e.g., cancer, obesity, type 2 diabetes, et al.), and neurological disorders based on a decade of research. SFN exerts its biological functions through the hydrolysis of glucosinolates by gut microbiota, and exhibits rapid metabolism and excretion characteristics via metabolization of mercapturic acid pathway. Microencapsulation is an important way to improve the stability and targeted delivery of SFN. The health benefits of SNF against CID are attributed to the multiple regulatory mechanisms including modulating oxidative stress, inflammation, apoptosis, immune response, and intestinal homeostasis. The clinical applications of SFN and related formulations show promising potential; however, further exploration is required regarding the sources, dosages, toxicity profiles, and stability of SFN. Together, SFN is a natural product with great potential for development and application, which is crucial for the development of functional food and pharmaceutical industries.

High intraoperative fluid load associated with prolonged length of hospital stay and complications after non-cardiac surgery in neonates.

Inappropriate perioperative fluid load can lead to postoperative complications and death. This retrospective study was designed to investigate the association between intraoperative fluid load and outcomes in neonates undergoing non-cardiac surgery. From April 2020 to September 2022, 940 neonates who underwent non-cardiac surgery were retrospectively enrolled and their perioperative data were harvested for further analysis. According to recorded intraoperative fluid volumes defined as ml.kg-1 h-1, patients were mandatorily divided into quintile with fluid load as restrictive (quintile 1, Q1), moderately restrictive (Q2), moderate (Q3), moderately liberal (Q4), and liberal (Q5). The primary outcomes were defined as prolonged length of hospital stay (LOS) (postoperative LOS ≥ 14 days), complications beyond prolonged LOS, and 30-day mortality. Secondary outcomes included postoperative complications within 14 days of hospital stay. The intraoperative fluid load was in Q1 of 6.5 (5.3-7.3) (median and IQR); Q2: 9.2 (8.7-9.9); Q3: 12.2 (11.4-13.2); Q4: 16.5 (15.4-18.0); and Q5: 26.5 (22.3-32.2) ml.kg-1 h-1. The odd of prolonged LOS was positively correlated with an increase fluid volume (Q5 quintile: OR 2.602 [95% CI 1.444-4.690], P = 0.001), as well as complications beyond prolonged LOS (Q5: OR 3.322 [95% CI 1.656-6.275], P = 0.001). The overall 30-day mortality rate was increased with high intraoperative fluid load but did not reach to a statistical significance after adjusted with confounders. Furthermore, the highest quintile of fluid load (26.5 ml.kg-1 h-1, IQR [22.3-32.2]) (Q5 quintile) was significantly associated with longer postoperative mechanical ventilation time compared with Q1 (Q5: OR 2.212 [95% CI 1.101-4.445], P = 0.026).    Conclusion: Restrictive intraoperative fluid load had overall better outcomes, whilst high fluid load was significantly associated with prolonged LOS and complications after non-cardiac surgery in neonates.    Trial registration:  Chictr.org.cn Identifier: ChiCTR2200066823 (December 19, 2022). What is Known: • Inappropriate perioperative fluid load can lead to postoperative complications and even death. What is New: • High perioperative fluid load was significantly associated with an increased length of stay after non-cardiac surgery in neonates, whilst low fluid load was consistently related to better postoperative outcomes.

Comparison analysis of bioactive metabolites in soybean, pea, mung bean, and common beans: reveal the potential variations of their antioxidant property.

This study showed the significantly differences of basic nutrients and metabolite compounds in nine types of beans involved in soybean, mung bean, pea, and common beans. The metabolomics results showed that serval metabolites such as histidine, proline, 3-alanine, and myricetin which could be used to identify different beans. The random forest model showed that amino acid and fatty acid could be used as special indexes to distinguish different types of beans in practice. The different expressed metabolites among different types of beans were involved in various pathways including alanine, aspartate and glutamate metabolism, arginine and proline metabolism, and purine metabolism. The antioxidant activity was significantly different among different types of beans, and the contents of amino acid, coumarin, and polyphenol contributed the antioxidant activities of beans. Together, these results will provide a comprehensive understanding of metabolites in different types of beans and theoretical guideline for the future application of beans.

TRIM11 expression levels was downregulated and prevents ferroptosis of cardiomyocyte by Dusp6 in acute myocardial infarction.

Acute myocardial infarction (AMI) is the high incidence rate and mortality of common cardiovascular disease. Herein, we explored the critical role of TRIM11 in AMI and its underlying mechanism. Serum from patients with AMI were collected from our hospital. Mice of model group received angiotensin II. Mice of model + TRIM11 group received with Ang II and TRIM11 vectors. Mice of sham group received normal saline. H9c2 cells were performed transfections using Lipofectamine 2000 (Thermo Fisher Scientific Inc, Shanghai, China), and treated with Ang II. TRIM11 mRNA expression was reduced, was negative correlation with collagen I/III mRNA expression, systolic blood pressure, diastolic blood pressure, left anteroposterior atrial diameter, right atrial diameter, or left ventricular ejection fraction in patient with AMI. TRIM11 mRNA and protein expression were also suppressed. METTL3 regulates TRIM11 methylation to reduce TRIM11 gene stability in model of AMI. TRIM11 gene ameliorated AMI in mice model. TRIM11 gene reduced reactive oxygen species production level of cardiomyocyte in-vitro model. TRIM11 gene reduced ferroptosis of cardiomyocyte in-vitro model. TRIM11 gene reduced ferroptosis by the inhibition of mitochondrial damage of cardiomyocyte in model of AMI. TRIM11 induced Dusp6 protein expression. Bioluminescence imaging showed that TRIM11 virus increased Dusp6 expression in heart tissue of mice model. The inhibition of Dusp6 reduced the effects of TRIM11 on ferroptosis of cardiomyocyte in model of AMI. In conclusion, this study demonstrates that TRIM11 improves AMI by regulating Dusp6 to inhibit ferroptosis of cardiomyocyte, and suggest a novel target for AMI.

Exploring the Relationship between Small Peptides and the T1R1/T1R3 Umami Taste Receptor for Umami Peptide Prediction: A Combined Approach.

Umami peptides are known for enhancing the taste experience by binding to oral umami T1R1 and T1R3 receptors. Among them, small peptides (composed of 2-4 amino acids) constitute nearly 40% of reported umami peptides. Given the diversity in amino acids and peptide sequences, umami small peptides possess tremendous untapped potential. By investigating 168,400 small peptides, we screened candidates binding to T1R1/T1R3 through molecular docking and molecular dynamics simulations, explored bonding types, amino acid characteristics, preferred binding sites, etc. Utilizing three-dimensional molecular descriptors, bonding information, and a back-propagation neural network, we developed a predictive model with 90.3% accuracy, identifying 24,539 potential umami peptides. Clustering revealed three classes with distinct logP (-2.66 ± 1.02, -3.52 ± 0.93, -2.44 ± 1.23) and asphericity (0.28 ± 0.12, 0.26 ± 0.11, 0.25 ± 0.11), indicating significant differences in shape and hydrophobicity (P < 0.05) among potential umami peptides binding to T1R1/T1R3. Following clustering, nine representative peptides (CQ, DP, NN, CSQ, DMC, TGS, DATE, HANR, and STAN) were synthesized and confirmed to possess umami taste through sensory evaluations and electronic tongue analyses. In summary, this study provides insights into exploring small peptide interactions with umami receptors, advancing umami peptide prediction models.

A Manganese-Based Nanodriver Coordinates Tumor Prevention and Suppression through STING Activation in Glioblastoma.

Glioblastoma (GBM), the most prevalent and aggressive primary malignant brain tumor, exhibits profound immunosuppression and demonstrates a low response rate to current immunotherapy strategies. Manganese cations (Mn2+) directly activate the cGAS/STING pathway and induce the unique catalytic synthesis of 2'3'-cGAMP to facilitate type I IFN production, thereby enhancing innate immunity. Here, a telodendrimer and Mn2+-based nanodriver (PLHM) with a small size is developed, which effectively target lymph nodes through the blood circulation and exhibit tumor-preventive effects at low doses of Mn2+ (3.7 mg kg-1). On the other hand, the PLHM nanodriver also exhibits apparent antitumor effects in GBM-bearing mice via inducing in vivo innate immune responses. The combination of PLHM with doxorubicin nanoparticles (PLHM-DOX NPs) results in superior inhibition of tumor growth in GBM-bearing mice due to the synergistic potentiation of STING pathway functionality by Mn2+ and the presence of cytoplasmic DNA. These findings demonstrate that PLHM-DOX NPs effectively stimulate innate immunity, promote dendritic cell maturation, and orchestrate cascaded infiltration of CD8 cytotoxic T lymphocytes within glioblastomas characterized by low immunogenicity. These nanodivers chelated with Mn2+ show promising potential for tumor prevention and antitumor effects on glioblastoma by activating the STING pathway.

Critical roles of S100A12, MMP9, and PRTN3 in sepsis diagnosis: Insights from multiple microarray data analyses.

BACKGROUND: Sepsis, characterized by systemic inflammatory response syndrome and life-threatening organ dysfunction, remains a significant global cause of disability and death. Despite its impact, reliable biomarkers for sepsis diagnosis are yet to be identified. OBJECTIVE: This study aims to investigate and identify key genes and pathways in sepsis through the analysis of multiple microarray datasets, providing potential treatment targets for future clinical trials. METHODS: Two independent gene expression profiles (GSE54514 and GSE69528) were downloaded from the Gene Expression Omnibus (GEO) database. After merging and batch normalization, differentially expressed genes (DEGs) were obtained using the "limma" package. Gene Ontology (GO) and Gene Set Enrichment Analysis (GSEA) were performed using "R" software. A Protein-Protein Interaction (PPI) network was constructed using the Search Tool for the Retrieval of Interacting Genes (STRING). The top 10 hub genes were identified using Cytoscape. A Nomogram model for predicting sepsis occurrence was constructed and evaluated. RESULTS: Bioinformatic analysis of 210 sepsis and 91 control blood samples identified 72 DEGs. GO analyses revealed associations with immune response processes. GSEA indicated involvement in key signaling pathways. S100A12, MMP9, and PRTN3 were identified as independent risk factors for sepsis. CONCLUSION: This study unveils critical genes and pathways in sepsis through bioinformatic methods. S100A12, MMP9, and PRTN3 may play essential roles in the immune response to infection, influencing sepsis prognosis.

Difficulties faced by intensive care nurses in caring for patients with delirium: A cross-sectional, multicentre study.

BACKGROUND: Intensive care nurses experience many difficulties in caring for patients with delirium. Thus, it is valuable to conduct in-depth research on the factors that influence the difficulties faced by intensive care nurses in caring for those with delirium as doing so can result in tangible improvements in patient outcomes. OBJECTIVES: The objective of this study was to explore the difficulties faced by intensive care nurses in caring for patients with delirium in light of the demographic, clinical, and professional and management characteristics of nurses. METHODS: A cross-sectional study involving 360 intensive care nurses from eight general hospitals in Taizhou, Zhejiang Province, China. The participants completed questionnaires assessing the level of difficulty they faced in caring for patients with delirium and their level of delirium-related knowledge. RESULTS: The highest overall mean scores on the difficulty scale subscales were observed for ensuring safety (2.92 ± 0.30), dealing with stress and distress (2.80 ± 0.37), and lack of resources (2.85 ± 0.41). The main factors influencing nurses' difficulty in caring for these patients were title, status as a critical care specialist nurse, training regarding delirium, a standardised delirium management process, the knowledge level regarding delirium, the total number of years working in the intensive care unit, and work communication ability. Likewise, most of these characteristics made it difficult for the nurses to use delirium screening tools. CONCLUSIONS: This study provides insights into factors influencing the difficulties faced by intensive care nurses in caring for patients with delirium and in using delirium screening tools. Our findings suggested that nursing managers could develop targeted improvement strategies and provide more resources to support nurses, thereby improving the quality of delirium care and patient outcomes by using the results from this study. These findings can also provide evidence to support intervention studies in the future.